Cognitive–behavioural therapy and motivational intervention for schizophrenia and substance misuse

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Abstract
Background: Comorbid substance misuse in people with schizophrenia is associated with poor clinical and social outcomes. There are few studies of psychological treatments for this population and little long-term follow-up of their benefits.Aims: To investigate symptom, substance use, functioning and health economy outcomes for patients with schizophrenia and their carers 18 months after a cognitive–behavioural treatment (CBT) programme.Method: Patients with dual diagnosis from a randomised controlled trial of motivational intervention, individual CBT and family intervention were assessed on multiple outcomes at 18-month follow-up. Carers were assessed on symptom, functioning and needs over 12 months. Health economy data were collected over 18 months.Results: There were significant improvements in patient functioning compared with routine care over 18 months. No significant differences between treatment groups were found in carer or cost outcomes.Conclusions: The treatment programme was superior to routine care on outcomes relating to illness and service use, and the cost was comparable to the control treatment.

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